Cure for health care ills no easy fix, doctors say

GREENVILLE, N.C.
(Nov. 18, 2009)
—
The U.S. health care system needs a lot of work, but no one bill before Congress has all the answers. That was the message from a pair of Brody School of Medicine faculty members who discussed federal health care reform measures Tuesday night.

Dr. Charles Willson, clinical professor of pediatrics and chair of the N.C. Health and Wellness Trust Fund Commission; and Dr. Stephen Powell, East Carolina University professor of cardiovascular sciences and a vascular surgeon, took opposing viewpoints on some topics but agreed on several others during a health care reform debate organized by medical students.

Dr. Paul Cunningham, dean of the Brody School of Medicine, was the moderator. The event was held in the Brody Medical Sciences Building.

"We don't have a health care system. We have a sick care system," Willson said. "We have a system perfectly designed to save your life at a cost of hundreds of thousands of dollars."

He also described the health care system as one in which millions of Americans are "one pink slip away" from losing their insurance coverage. "We cannot be the country we can be and ought to be until all our people have access to health care and don't have to worry about going broke."

Powell said the health care reform bill recently passed by the House of Representatives, H.R. 3962, or the Affordable Health Care for America Act, is hastily assembled, crowded with special interest provisions, does nothing to reduce costs and will add to the national debt. He said today's medical students will pay the costs.

He also predicted rationing will occur when people who don't have insurance are able to obtain insurance under the House plan, especially in a health care system that faces high costs and workforce shortages.

"Government health care programs would be forced to severely restrict services, ration care or deny care to save money," Powell said. "Adding more health care in a broken system will accelerate the breakdown of that system ... and lead to a rationing scenario. You can't have something for nothing."

The physicians also seemed to disagree on the question of whether health care is a right.

"Is food a right?" Powell asked. "Is it a right for people to have houses? Is it a right for people to have cars? You cannot have something for nothing."

Willson responded by saying, "I'm not smart enough to know if health care is a right, but I know it's good public policy if all Americans can be afforded the chance to be as healthy as they possibly can."

Both, however, agreed on several points. A limit on non-economic damages in medical malpractice suits is needed, people with pre-existing conditions should be able to buy affordable health insurance, reduce fraud and abuse in Medicare, and promote primary care "medical homes" for patients.

"A place where everyone knows your name," like at "Cheers," the 1980s television tavern, Willson said in describing what a medical home is.

Both also said doctors should play a more active role in making sure lawmakers and the public know more about the health care system, its problems and potential solutions. They also agreed that without change, severe challenges loom.

"We have a recipe for disaster with increasing costs, poor value delivered," Willson said. "We are going to have more and more rationing whether we want it or not."